Antiarrhythmic drugs for atrial fibrillation?

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Johann Pagac asked a question: Antiarrhythmic drugs for atrial fibrillation?
Asked By: Johann Pagac
Date created: Tue, Mar 30, 2021 12:30 PM
Date updated: Wed, Jun 22, 2022 9:51 PM

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Six antiarrhythmic drugs are often used to treat atrial fibrillation: propafenone (Rhythmol), flecainide (Tambocor), sotalol (Betapace), dofetilide (Tikosyn), amiodarone (Cordarone), and dronedarone (Multaq).

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Six antiarrhythmic drugs are often used to treat atrial fibrillation: propafenone (Rhythmol), flecainide (Tambocor), sotalol (Betapace), dofetilide (Tikosyn), amiodarone (Cordarone), and dronedarone (Multaq).

Amiodarone, although not approved by the Food and Drug Administration for AF, is the most commonly prescribed antiarrhythmic drug for AF, representing 45% of annual drug prescriptions. 8 It is a complex iodinated compound that, along with its active metabolite N -desethylamiodarone, blocks I Kr, I Na, I Kur, I to, I CaL, I KAch, and I f channels with noncompetitive antagonism of α- and β-receptors.

The main antiarrhythmic drugs used in treatment of AF are propafenone, flecainide, beta-blockers, amiodarone, dronedarone, dofetilide, vernakalant, and ranolazine.

The value of class IC antiarrhythmic drugs for acute conversion of paroxysmal atrial fibrillation or flutter to sinus rhythm. J Am Coll Cardiol. 1990 Dec; 16 (7):1722–1727. Donovan KD, Dobb GJ, Coombs LJ, Lee KY, Weekes JN, Murdock CJ, Clarke GM. Reversion of recent-onset atrial fibrillation to sinus rhythm by intravenous flecainide. Am J Cardiol. 1991 Jan 15; 67 (2):137–141. Faniel R, Schoenfeld P. Efficacy of i.v. amiodarone in converting rapid atrial fibrillation and flutter to sinus ...

Amiodarone, with its multiple extra-cardiac side effects, remains the most efficient anti-arrhythmic drug. Although less efficient, other options for selected cases, are sotalol, dronedarone or vernakalant [ 4 ]. Several non-antiarrhythmic drugs demonstrated preventive abilities especially when applied for risk factors (upstream therapy).

Ranolazine is an antianginal drug whose major mechanism of action is blockade of the late sodium current. It also has weaker effects on Ikr.

New antiarrhythmic drugs for atrial fibrillation: focus on dronedarone and vernakalant. Camm AJ (1), Savelieva I.

Suppression of AF can be achieved with antiarrhythmic drugs that have favorable electrophysiologic effects in the atria. 1,12,13 Such drugs include quinidine, procainamide, disopyramide, moricizine, flecainide, propafenone, sotalol, amiodarone, and dofetilide.

The antiarrhythmics most commonly used to maintain normal sinus rhythm in atrial fibrillation patients are the class IC agents flecainide and propafenone and the class III agents amiodarone, dronedarone, sotalol, and dofetilide.

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